May 9, 2020

We Owe It to Canadians to Transform Long-Term Care

The CFNU supports the Canadian Labour Congress’ call on the government to immediately convene an emergency task force, which must include labour unions, to develop a plan for a comprehensive universal long-term care system that is publicly funded and exclusively not-for-profit.

Long-term care is an essential service for seniors and others who require 24-hour nursing care. However, 36 years after the passage of the Canada Health Act, long-term care is still not considered a core, publicly funded service and is not governed by federal regulations. As such, it is grossly under-resourced and understaffed, with little to no enforcement of even the most basic standards of care.

More than half of long-term care residents are 85 and older. The vast majority of residents have some form of cognitive impairment; most require extensive help with daily activities. As the CLC report details, successive federal and provincial governments have failed to take action to improve the lives of this vulnerable population.

Faced with a highly contagious virus, the long-term care sector was unable to mount a strong defence. Its fragmented system, made up of public, not-for-profit and private (for-profit) establishments, impeded a centralized approach to stemming the spread of COVID-19. Most long-term care facilities pack seniors into rooms with very little space between residents; the lack of space in facilities has directly contributed to the rapid spread of the virus. Those employed directly by long-term care homes have to contend with low wages and precarious work conditions: largely part-time, casual and contract-based jobs with little or no benefits. As a result, many long-term care employees are forced to work in more than one nursing home or more than one job, increasing the potential for the virus to spread across facilities.

Given how vastly residents outnumber staff, it comes as no surprise that a CFNU survey found that residents often suffer from lack of timely care and, at times, omitted care. Current staffing levels are insufficient to meet the needs of this vulnerable population. The CFNU has also revealed in a recent discussion paper that violence between residents and against staff is endemic in this sector. Decades-old research shows that 4.1 direct hours of care per resident per day is required to ensure that seniors’ health isn’t eroded; according to research commissioned by the CFNU, quality care for seniors requires a minimum of 4.5 hours of direct care per resident per day, with at least one RN on site per shift.

COVID-19 was able to spread like wildfire through long-term care homes, fuelled by insufficient staffing and a lack of basic standards. About 80% of deaths related to COVID-19 in Canada have occurred in long-term care, with most deaths concentrated in Ontario and Quebec. The vast majority of deaths from the virus in Nova Scotia have also been in long-term care homes. It has taken thousands of tragic deaths to finally shine a light on the deplorable conditions that exist in many long-term care homes, impacting both staff and residents. Over the past five years, the CFNU and its Member Organizations have repeatedly stressed the fragility of long-term care at the federal level, as well as in provincial-level reports in Nova Scotia and Manitoba. These reports reveal the link between chronic understaffing, high workloads, demoralized workers and unsafe workplaces.

The CFNU supports the Canadian Labour Congress’ call on the government to immediately convene an emergency task force, which must include labour unions, to develop a plan for a comprehensive universal long-term care system that is publicly funded and exclusively not-for-profit. Long-term care must follow the principles of the Canada Health Act. Targeted federal funding for long-term care, directed at the provinces and territories, needs to be expanded and increased, with conditions attached that include standards for staffing levels, training, protective equipment, as well as decent working conditions, wages and benefits for long-term care workers.

The CFNU would welcome the opportunity to lend its expertise towards this effort.